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Francine R. Villareal .=tfl w,..,oziaasaaa:.ord9age 1 0£ 2 A� o® CERTIFICATE OF LIABILITY INSURANCE D05/04ATE I/2021Y OS/09/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Willis Towers Watson Northeast, Inc. c/o 26 Century Blvd CONTACT Crown Castle International NAME: PHONE FAX AIC No): P.O. Box 305191 E-MAIL DDRESSCOIRe estlicrowncastle.com A: qu INSURER(S) AFFORDING COVERAGE NAICB Nashville, M 372305191 USA INSURER A: Federal Insurance Company 20281 INSURED Crown Castle international INSURER B: National union Fire Insurance Company of P 19445 INSURER C: Berkshire Hathaway Specialty Insurance Cos 22276 See Attached Named Insured List INSURER D: AID Insurance Company 19399 1220 Augusta Dr. Suite 600 Houston, TX 77057 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W20873940 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSD WM POLICYNUMBER POLICY EFF MM)DD/YYYY POLICY UP MM/DO)YYYY LIMITS X COMMERCIALGENERAL LIABILITY CLAIMS -MADE OCCUR URRENCE $ 1,000,000 RENTED11000,000 Ea occunence $AAny one person) $ 10,000 Y Y3605-33-35 LIO 04/01/2021 04/01/2022&ADV INJURY MCOMBINED $ 1,000,000 GEN'L AGGREGATE LIMIT APPLI ES PER: POLICY JE�LUC AGGREGATE $ 2,000,000 S-COMPIOP AGG 2,000,000 $OTHER: $ AUTOMOBILE LIABILITY SINGLELIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) S ANY AUTO e OWNED SCHEDULED AUTOS ONLY AUTOS Y Y CA 7030894 04/01/2021 04/01/2022 BODILY INJURY(Peraocimma) $ HIRED NON-0WNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Par accident $ $ C X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE S 5,000,000 EXCESS LIAR CIAIMS-MADE y 47-UHO-303445-07 04/01/2021 04/01/2022 DEO X RETENTION$ 25,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILRY y / N ANYPROPRIETOR/PARTNERIEXECUTIVE No BEREXCLUDED? OFFICERIMEM393106 N/A T WC 016 04/01/2021 04/01/2022 X PER OTH- STATUTE OR E.L. EACH ACCIDENT $ 1,000,000 E , DISEASE -EA EMPLOYE $ 1,000,000 (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS)VEHICLES (ACORD 101, Additional Remarks Schedule, maybe anached if more space is required) RE: MUNICIPAL FACILITIES LICENSE AGREEMENT - Site Location: Public Rights -of -Way - Various Site Locations - Named Insured: Crown Castle Fiber LLC City of Santa Ana (Licensor), its council members, officers, and employees are included as Additional Insureds under the General Liability and Auto Liability policies as their interest may appear and as required by written agreement and only with respect to the liability arising out of the operations performed by or on behalf of the Named Insured. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana. CA 92702 ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1��_ The ACORD name and logo are registered marks of ACORD ruvmgr.rc vwuum •Mar��i' CCREVIEV/ED 61I�A�PPR��O/�V/(ED Sr. rMLfYnM[ ram. V+CWMFL Imo. Risk Management Malys) SR ID: 21058122 BATCH: 2081195